The inquest into the death of a woman who died from a pulmonary embolism arising from deep vein thrombosis (DVT) in her left calf has returned a narrative verdict and raised questions over whether enough advice is given regarding DVT.
Christine Bayliss, aged 61, of Close y Locker, Union Mills, died on April 13, 2013, in the accident and emergency department of Noble’s Hospital after being taken ill at her home.
Coroner John Needham said, while delivering his verdict: ‘Christine was clearly a great family lady.
‘She was a great friend to her daughter, Karen, and of great assistance to her.’
But the family of Mrs Bayliss hit out at the hospital with daughter Karen Freestone saying in a prepared statement: ‘I feel let down by Noble’s. I feel my mother would have still been with us today if she had received better aftercare.’
Mrs Bayliss’s family said that she hadn’t been given enough advice on avoiding DVT but medical staff at Noble’s denied this.
Medical reports revealed that the deceased had also injured her left ankle in 1981 and was clinically obese.
The court heard how on March 24 Mrs Bayliss had attended the accident and emergency department after her ankle ‘gave way’ coming out of the National Sports Centre in Douglas.
After an examination and X-ray her ankle was found to be broken and a ‘backslab’ plaster cast was put on it, a slab of plaster which does not completely encircle the limb.
On March 27 Mrs Bayliss returned to the hospital and a new weight-bearing plaster cast was put on her leg, which encourages the wearer to put more weight on the limb.
Another appointment was then made for April 10 at which her cast was removed to review how her ankle was progressing and a new cast was put back on.
Dr Suddhajit Sen, an orthopaedic surgeon at Noble’s, examined Mrs Bayliss and said that there was no sign of redness or swelling to cause alarm.
That evening it was said that Mrs Bayliss could not sleep and was in discomfort and crying.
She returned to the hospital the next day, April 11, saying the cast felt loose and it was removed but there were said to be no sores or any visible presence of deep vein thrombosis.
Medical staff said that Mrs Bayliss did not mention the pain and discomfort she had felt in the night, and her leg was replastered.
On April 12 she was in Douglas town centre shopping with her husband Geoffrey and began complaining of breathlessness and a pain in her hand.
On the morning of April 13 Mrs Bayliss, who was staying at her daughter’s home, woke up feeling very ill in pain and appeared to be choking.
She went to the bathroom to be sick and her grandson rang Mr Bayliss who immediately went round to their daughter’s house.
They called emergency services and Mr Bayliss sat holding his wife’s hand but said she then ‘went rigid’.
Paramedics arrived but she was later pronounced dead at Noble’s Hospital.
The court heard evidence from Dr Ervine Long, consultant pathologist, who carried out the post-mortem examination, orthopaedic surgeon Dr Suddhajit Sen, consultant orthopaedic surgeon Ross Barker and Dr Maric Thorpe, consultant in accident and emergency medicine, as well as nursing staff who were involved in treating Mrs Bayliss.
Prepared statements were read from the deceased’s husband, Geoffrey, and daughter, Karen Freestone, paramedic who attended the scene, Jason Gaunt, Noble’s case manager Amanda Mills and Constable Mark Moyer.
Mr Needham questioned medical staff from Noble’s whether appropriate advice had been given to Mrs Bayliss but they insisted that aftercare information leaflets had been handed to her on each visit to the hospital and verbal advice given, something which her family disputed.
He also reviewed seven other aftercare leaflets from other hospitals around the UK.
Only two of the seven warned that breathlessness could be a symptom of DVT. The Noble’s leaflet did not. The Noble’s leaflet also contained cartoons which Mr Needham said was perhaps not appropriate in such a serious matter.
The coroner said he would be writing a letter of recommendation regarding looking for signs of DVT with his findings.
In closing Mr Needham said: ‘One can’t say if a clearer leaflet would have helped. We also can’t say if Mrs Bayliss had sought help the day before she died if the pulmonary embolism could have been treated.
‘Maybe changes will come in the way of leaflets and there may be some small benefit from this.
‘Factors such as Christine’s age and weight would have put her in the “at risk” category.
‘I don’t think there is scope to record neglect, a narrative verdict seems appropriate.’